<p>Processing hard and brittle materials typically involves extensive rough grinding, often resulting in material damage. In this paper, ultrasonic vibration-assisted machining (UVAM) is applied to the rough grinding of zirconia ceramics, achieving both high efficiency and minimal damage. We systematically studied the axial ultrasonic vibration-assisted end grinding (AUEG) of zirconia ceramics, and smooth surfaces with little damage were obtained across a wide range of cutting depths (2–20 µm). This paper presents a novel theoretical model for the grinding process of AUEG, dividing the grinding process into Stage I (initial machined surface creation) and Stage II (machined surface refinement). In Stage I, ultrasonic vibration facilitates the nucleation of microcracks and reduces crack size. In Stage II, the cutting depth is varied between 0 and amplitude, and the abrasive grains dynamically remove the residual damage generated in Stage I in the form of a plastic flow. The model is supported by analyses of the machined surface and subsurface quality, as well as grinding forces. Results indicate that, with appropriate ultrasonic amplitude, the surface morphology is dominated by plastic flow and brittle damage is significantly reduced. The surface roughness Sa was reduced from a maximum of 663.2 to 146.78 nm. In addition, AUEG significantly reduced the grinding force fluctuation with the variation coefficients of grinding force reduced from a maximum of 8.46 to 3.2% (<i>Fx</i>), 7.81 to 2.14% (<i>Fy</i>), and 6 to 3.92% (<i>Fz</i>), respectively. This study provides support for high-quality and high-efficiency grinding of hard and brittle materials.</p>